Pharmacist Call Center - San Juan, PR

UnitedHealth Group; San Juan (PR); On-site; USD 80,000 - 110,000; Full time

Job summary

UnitedHealth Group is seeking a Clinical Pharmacist in San Juan, Puerto Rico, to perform telephonic consultations with members. This role involves overseeing medication reviews, ensuring adherence, and improving disease management while adhering to HIPAA regulations. The ideal candidate will have excellent organizational skills and a current Pharmacist license, with a preference for PharmD and bilingual proficiency in English and Spanish. The role requires flexibility to work rotating shifts from 10:00am to 8:00pm CST, Monday through Friday.

Qualifications

• Must have experience in a cross-functional team environment.
• Solid knowledge of disease state management guidelines required.
• Proficiency with MTM platforms and technology necessary.

Responsibilities

• Engage members telephonically for consultations.
• Document care delivered and communicate with primary care providers.
• Prioritize patient privacy and adhere to HIPAA regulations.

Skills

Pharmaceutical knowledge

Telephonic consultative skills

Bilingual proficiency in English and Spanish

Organizational skills

Education

Current and unrestricted Pharmacist license

PharmD (preferred)

Tools

Microsoft Word

Microsoft Outlook

Microsoft Excel

Job description

The Clinical Engagement Services Center team provides a variety of clinical services, such as: Adherence, Diabetes, Fraud Waste & Abuse, Medication Therapy Management, PolyPharmacy, Retrospective Drug Utilization, and STARS adherence.

The team comprises of clinical pharmacists, clinical nurses, certified pharmacy technicians, and customer service representatives that complete various functions to successfully meet the operational requirements of each clinical service. The work hours required will require flexibility to work rotating shifts between the hours of 8:00am and 8:00pm CST, Monday through Friday.

The Clinical Pharmacist will report into the Operations Team Manager. This role is primarily responsible for performing telephonic consultations with members to complete comprehensive medication reviews, adherence related consults, and improve disease state management. In addition, the clinical pharmacist will document the care delivered and communicate essential information to the member's primary care providers.

Primary Responsibilities

• Engage members telephonically and schedule pharmacist consultation appointments with members that participate in any of the clinical programs operationally supported by the Clinical Engagement Services Center
• Prioritize the privacy and confidentiality of the patient's medical information, adhering to HIPAA regulations, and organizational policies at all times
• Utilize prescription claims data to generate clinical recommendations according to Medication Therapy Management and Retrospective Drug Utilization Review program protocols providing clinical recommendations pertaining to, but not limited to, gaps in care, high risk medications, compliance and adherence, drug interactions, therapeutic substitution, and generic substitution
• Assess medication regimen for unnecessary medications, ineffective medications, inappropriate doses, and adverse drug reactions
• Provide patient education on medication regimen and disease states
• Accurately document patient care notes and recommendations in an efficient, professional, concise and clear manner
• Keep current with new and emerging clinical trends
• Active participation in departmental meetings to improve clinical programs and enhance processes
• Follow all policies and procedures related to job
• Meet productivity and performance expectations set forth by management
• Support Clinical Service Engagement team as needed for special projects
• Other duties as assigned by Operations Manager

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• Current and unrestricted Pharmacist license in the state of residence
• 1+ years of experience working remotely/independently within a cross functional team environment, self-directed with excellent organizational skills
• Solid knowledge of disease state management guidelines and the 5 Core Elements of MTM Services (1) Medication Therapy Review - Comprehensive and Targeted, 2) Personal Medication List (PML), 3) Medication-Related Action Plan (MAP), 4) Interventions and Referrals, and 5) Documentation of Services and Follow-up)
• Intermediate level of proficiency with Microsoft Word, Outlook, and Excel
• Ability to navigate approved MTM platforms and multi-task using multiple databases/platforms, and applications. Competent use of computers/technology
• Ability to work a flexible schedule with rotating shifts between the hours of 10:00am and 8:00pm CST, Monday through Friday. Extended hours and occasional weekends may be required as needed
• Bilingual proficiency in English and Spanish

Preferred Qualifications

• PharmD
• Current and active Certified Diabetes Care and Education Specialist, Board Certified-Advanced Diabetes Management, ASHP Diabetes Management Certificate, or APhA Patient Centered Diabetes Care Certificate
• Additional Pharmacist License in good standing in Alabama, Idaho, Kentucky, Louisiana, Maryland, Minnesota, Oregon, Tennessee, or Vermont
• Pharmacy work experience in retail / community pharmacy and / or PBM, but will consider new graduate experientials
• Call center experience
• ACPE MTM Specialist
• Certified Geriatric Specialist
• Board Certified Pharmacist

Soft Skills

• Demonstrates interpersonal, consultative, and problem‑solving skills - Ability to ask questions to understand patient needs while having empathy and actively listening
• Solid telephonic skills - Ability to speak clearly and communicate with senior citizens and healthcare professionals
• Capable of defusing conflict appropriately with solid conflict management skills
• Commitment to professionalism and a dedicated desire to advance patient care
• Ability to interact cross functionally within the organization
• Excellent attention to detail, time management, organizational, and prioritization skills and ability to balance multiple priorities

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.